NUTRITIONAL, MICROBIOLOGICAL, AND THERAPEUTIC FACTORS RELATED TO MUCOSITIS IN HEAD AND NECK CANCER PATIENTS: A COHORT STUDY.

NUTRITIONAL, MICROBIOLOGICAL, AND THERAPEUTIC FACTORS RELATED TO MUCOSITIS IN HEAD AND NECK CANCER PATIENTS: A COHORT STUDY.

Nutrición Hospitalaria, September 2015

26319840

Alfonso Vidal-Casariego, Isabel Fernández-Natal, Alicia Calleja-Fernández, Trinidad Parras-Padilla, Isidoro Cano-Rodríguez, Begoña Prieto-Alonso, María D Ballesteros-Pomar

the objective was to demonstrate if treatment modality, nutritional status and oropharyngeal flora contribute to the development of mucositis in radiotherapy- treated head and neck cancer. single-cohort study of patients with head and neck cancer (H&N) in which radiotherapy was indicated. Nutritional status was evaluated using SGA, BMI, and FFMI. A buccal smear was performed before radiotherapy for cultivation of bacteria and yeasts. Mucositis was evaluated using the WHO grades. Relative risk (RR) and its 95% CI were calculated. the study included 35 patients, 74.3% males, 63.8 (9.9) years of age, and 34.3% malnourished. The diagnoses included larynx (40.0%), oral (25.7%), and pharynx cancer (11.4%). Treatment comprised 66.0 Gy of radiation, chemotherapy (60.0%), and surgery (57.1%). Bacteria were found in 28.6%, including Staphylococcus aureus (8.6%) and Escherichia coli (8.6%). Yeasts (Candida spp.) were found in 35.3%. Mucositis was more frequent in patients with definitive radiotherapy [100% vs. 65%, p = 0.01; RR = 1.54 (CI95% 1.12 to 2.12)]. Neither SGA nor BMI or FFMI were related to the development or severity of mucositis. Positive cultures for bacteria before radiotherapy were related to severe mucositis [44.4% vs. 12%, p = 0.039; RR = 4.17 (CI95% 1.22 to 14.24)], but there was no relationship with the presence of yeasts. Previous surgery was not associated with the appearance of the studied strains of bacteria. bacterial colonization of the oropharynx prior to radiotherapy may be a factor for severe mucositis in H&N patients.